Check on assessments and funding

All about caring
,
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Checkpoint understanding specifically thinking more about eldercare
Perhaps I’m confused…can you set me straight pls

In the MIND website the simple explanation difference between Healthcare and social care is:
It can sometimes be difficult to say whether a service you receive is health or social care. Healthcare is generally provided free under the NHS. Social care is provided by local authorities, who can charge for it.​

  • ​A healthcare need is related to the treatment, control or prevention of a disease, illness, injury or disability. And the care or aftercare of a person with these needs.

  • A social care need is focused on providing assistance with:

    • The activities of daily living

    • Maintaining independence

    • Social interaction

    • Enabling you to play a fuller part in society

    • Protecting you in vulnerable situations

    • Helping you to manage complex relationships

    • In some circumstances, accessing a care home or other supported accommodation

…
Then re. The NHS continuing healthcare framework It’s paid by the NHS and includes in-home nurse care

Social care = The Carer assessments (for Carers needs) and the Needs Assessment (for your loved one or the person you care for who has mental or physical illness or disability) are assessments of needs which may lead then, if you qualify, to a Financial Assessment and IF you have income or capital (solely or joint share) exceeding £23’250 the council can not provide or pay for services that meet those needs

And there is the hospital discharge assessment that - depending on types of needs can provide 6 weeks of care free (per NHS funding) or is part of continuing healthcare as above:
They will look to see if you/your loved one need any intermediate care, reablement care, NHS continuing healthcare, other NHS services and/or community care services eg/ from the local council or trust.

What is intermediate care? Services such as nursing, occupational therapy or physiotherapy designed to promote faster recovery. It can take place in a person’s home or at a day care facility or in residential care for up to six weeks (first six weeks should be free).

What are reablement services? After-care services to help people live more independently and prevent the risk of them going back into hospital. They are usually free for the first six weeks and goals are agreed with the patient.

What is NHS continuing healthcare? If after leaving hospital, you will have continued significant healthcare needs, you may be eligible for a package called NHS Continuing Healthcare – see our webpage for more details.

Bottom line: if we have more than £23’250 we have to sort our own services (with some ‘guidance’ from council of whats available?!), hospital discharge can trigger 6 weeks of support. Most important is that we need to stand strong for continuing healthcare support (funded by NHS) and not ‘let’ that be seen as a carer or our loved one’s needs assessment (ie social care cost provision)…

  • I realise there are different payment methods and benefits…but did I get the above right?!?
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It’s a pretty complex subject but you’ve pretty much encapsulated it as things stand currently.

There are some minor caveats where the differences are almost philosophical. For example: healthcare may involve administering medication, while social care involves only handing over the medication as prescribed for the individual to take themselves, or where there are agreed protocols for “home remedies” such as paracetamol for headaches.

Personal opinion: the distinction between health and social care is a false one and this needs to be addressed: the whole concept of good health is described as wellbeing: something that is listed as a factor in determining eligibility for social care…both are under the same government department and Secretary of State. But the department is basically run as two separate bodies - one funding and regulatory system for health, a completely different one for social care. It’s bonkers.

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Thanks @Charlesh47 I totally agree with your personal opinion… plus now people realise there should be ‘integrated’ care, ummm that was originally how it was back in the day when my Dad was a consultant geriatrician…
Scotland’s services are MUCH more joined up, and connected - when I lived up there the palliative to end of life to hospice for a family’s mother was amazing…
Basically, I don’t want the friends I’m trying to help when they’re already going thro a lot AND then to have to go through tons of questions, more time, angst and energy when it will all end up on them to organise anyways…

We’ll try to prioritise on getting support at home and an attendance allowance sorted for them…and NOT ‘waste’ precious energy …

In truest sarcasm…I’m more than a tad Riled by this. Wafting all the info out there, there’s a lot of hot air and when it comes down to nuts and bolts, especially outside London limited resources (not even talking about the quality of said care), and £23’250, for eldercare are the crunch points

I wonder what the new minister for Health and Social care will change if anything (Victoria Atkins)

Once I’ve discussed with friends, I’ll probably write another experience based article on my website…

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In theory, if someone has a PRIMARY health need, then the NHS pays for that need and the social need. There should be no gap between what Social Services fund and what the NHS Fund. (See the Grogan case). Reality can be very different.

In residential care, residents paying may get the Funded Nursing Care Allowance.

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Uhhhhhh 2021 to Oct 2023 the council would not provide care or pay for it if you have £23’350, right?
But now as of Oct 2023 there is a upper limit cap (ULC) of £86k

and in Oct 2025 the UCL become £100k

‘From October 2023, the government will introduce a new £86,000 cap on the amount anyone in England will need to spend on their personal care over their lifetime.
In addition, the upper capital limit (UCL), the point at which people become eligible to receive some financial support from their local authority, will rise to £100,000 from the current £23,250. As a result, people with less than £100,000 of chargeable assets will never contribute more than 20% of these assets per year. The UCL of £100,000 will apply universally, irrespective of the circumstances or setting in which an individual receives care, making it a much more generous offer than a previous proposal in 2015. The lower capital limit (LCL), the threshold below which people will not have to pay anything for their care from their assets will increase to £20,000 from £14,250.’

I’m still loathe to mention any of this to my friends because I don’t see how they can manage all the paperwork and still not get much care in their rural area!

@bowlingbun, @Charlesh47 thoughts?
I was thinking - I’m going to review a load of services and agencies in their area, whilst we set up a needs assessment, and while they review finances. This way we get a better idea of their needs and regardless of whether they are eligible / receive funding, we can organise some support right away…
So disheartening to have to go through all these hoops etc in difficult situation…

My thought is how on earth will the councils anywhere in the UK be able to organise all the social care needed for the significant number of people in the £23’250 to £100k …I don’t think there is any plan that I’ve heard of that’ll underpin this shift…have you?

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@Victoria_1806 It’s annoying that the government hasn’t changed the website or provided a link from that page, but in November 2022 they announced that the cap (and other reforms) would be delayed by two years. Basically, inflation got in the way. It was announced around the time of the “Autumn Statement”. Here’s a link from the BBC: Social care: What is happening to the cap on care costs? - BBC News - and another from the House of Commons Library: Proposed adult social care charging reforms (including cap on care costs) - House of Commons Library (parliament.uk)

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Ummm so I just found the NHS version: Paying for your own social care (self-funding) - Social care and support guide - NHS)

So there is no £86k Upper cap limit now there is ONLY the £23’250 and then in 2025 £100k capin 2025

bottom line after all those websites, information and press stuff

it’s still best to assess the local services and agencies ourselves because given the limited number of services AND people; ie the availability of support (not even talking about the standards or quality) will underpin if they can get help day to day or over the night…not even related to money

I don’t see any government health and social care plans for HOW more services; provision of care will be developed…even if they keep talking funding and money.

Thanks for clarifying for me @Charlesh47

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What they do have to do though is help anyone who wants it to find a care agency or home. They can, if you’re self-funding, charge you for it but it’s not generally hugely expensive and they can guide you through the system…so it’s probably worth it. At one time they could tell you that it’s all down to you if you’re self-funding.

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I’ve been involved with issues like this since I was 19, in various ways. The whole system is an absolute mess. The best system I’ve heard of long ago, so it may have changed now, was in New Zealand. They just got on and paid for what was needed, when it came to disability at least. I’ve reclaimed £8,000 from Hampshire who overcharged her, but even with a massive 28 different conditions the GP refused to apply for Continuing Healthcare until 2 days before she died, and then filled the forms in all wrong, so the application was rejected initially. I had to tell the CCCG that this indicated a training need for the GP, mum still qualified. By then she had died, and brother wouldn’t support an application retrospectively to reclaim £40.000! There’s an election coming up soon, anything could happen!!!

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Thanks @bowlingbun Hear you!, thanks to you and @Charlesh47 …appreciate your thoughts and input…Yep Autumn statement on Wednesday, Carers Rights Day Thursday and election next year…

regardless of what the news is, my friends still need support - potentially a rapid decline, so not going to chase my own tail and focus on what is poss for them

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In the case of a terminal diagnosis Continuing Healthcare, free, should be available. Some benefits can be applied for Fast Track without the knowledge of the person concerned. There should also be a special care plan drawn up by the GP so everyone knows what is going on. Never happened in my mum’s case though. And this is the heart of the problem. Mum’s GP didn’t want to do anything as “it would bankrupt the NHS!”

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